title: Incorrect position of Essure microinserts 3 months after successful bilateral placement.
abstract: OBJECTIVE
  To describe incorrect positions of Essure microinserts detected at 3 months' follow-up.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Outpatient department of obstetrics and gynecology in a Dutch teaching hospital.
  
  
  METHODS
  Initial series of 100 patients who underwent hysteroscopic sterilization using Essure between December 2003 and June 2004.
  
  
  METHODS
  Hysteroscopic placement of the Essure System, follow-up at 3 months with transvaginal ultrasound (TVU), and hysterosalpingography.
  
  
  METHODS
  Bilateral placement rate, tubal obstruction, and detection of incorrect Essure microinsert localization at follow-up after apparent successful bilateral placement.
  
  
  RESULTS
  Bilateral placement of Essure microinserts in one session was successful in 93 women (93%). In 90 of these women (96.8%), tubal obstruction was proven at follow-up 3 months later. Three incorrect positions of an Essure insert were seen: two expulsions and one perforation into the abdominal cavity.
  
  
  CONCLUSIONS
  Incorrect position of Essure microinserts was seen only when the initial placement procedure was difficult. When a placement procedure was difficult or other suboptimal conditions are present during the procedure, we advise performing a TVU or pelvic X-ray in these women 4 weeks after the procedure or after the first vaginal bleeding, instead of waiting for follow-up after 3 months.
authors.affiliation: University Medical Center, Utrecht, The Netherlands.
authors.forename: Maria B E
authors.initials: MB
authors.lastname: Gerritse
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Veersema
authors.forename: Anne
authors.initials: A
authors.lastname: Timmermans
authors.forename: Hans A M
authors.initials: HA
authors.lastname: Brölmann
mesh_terms: D000328:Adult; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007047:Hysterosalpingography; D015907:Hysteroscopy; D008875:Middle Aged; D011446:Prospective Studies; D012421:Rupture; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography